Assessment of urinary kidney injury molecule-1 and interleukin-18 in the early post-burn period to predict acute kidney injury for various degrees of burn injury

BMC Nephrology

Qing Cai¹  Xiaomei Luo³  Yifang Zhou⁴  Liangxi Wang⁴  Xiang Liu¹  Deshu Dai¹  Xuan Zhou¹  Hongqi Ren² 

[1] Department of Nephrology, HuaiHai Hospital of Xuzhou Medicine College, 226 Tongshan Road, XuZhou 221004, China;Department of Nephrology, Jinling Hospital, Nanjing Clinical College of Second Military Medical University, 305 Zhongshan East Road, Nanjing, China;Department of Clinical Laboratory, HuaiHai Hospital of Xuzhou Medicine College, 226 Tongshan Road, XuZhou 221004, China;Department of Burns, HuaiHai Hospital of Xuzhou Medicine College, 226 Tongshan Road, XuZhou 221004, China

关键词: Kidney injury molecule-1;    Acute kidney injury;    Interleukin-18;    Burns;   

Others  :  1223606
DOI  :  10.1186/s12882-015-0140-3

 received in 2014-09-17, accepted in 2015-08-06,  发布年份 2015

【 摘 要 】

Background

Burn patients with AKI have a higher mortality, rapid diagnosis and early treatment of AKI are necessary. Recent studies have demonstrated that urinary KIM-1 and IL-18 are potential biomarkers of early-stage AKI, however, changes in urinary KIM-1 and IL-18 levels are unclear in patients with burns. The aim of our study was to determine whether combined KIM-1 and IL-18 are more sensitive than traditional markers in detecting kidney injury in patients with burns.

Methods

Ninety-five burn patients hospitalized at the Burns and Plastic Surgery Center of our hospital from April 2013 to September 2013 were enrolled into this prospective study and divided into mild- (n = 37), moderate- (n = 30) and severe-burn groups (n = 28) by burn injury surface area. In the moderate- and severe-burn groups, patients were subcategorized to either the acute kidney injury (AKI) group, in which serum creatinine (Scr) increased to ≥26.5 μmol/L within 48 h, or the non-AKI group. Fifteen healthy subjects were selected as a control group. Blood specimens were collected to determine blood urea nitrogen (BUN), Scr, and other biochemical indicators. Urine samples collected at admission and 48 h after admission were analyzed for KIM-1 and IL-18. Correlations among urinary KIM-1 and IL-18, burn degree, and clinical biochemical indicators were investigated.

Results

AKI occurred in 11.2 % of burn patients (none in the mild-burn group). AKI developed 48 h after admission in 10.0 % of the moderate- and 28.6 % of the severe-burn groups. Urinary KIM-1 concentration in the moderate- and severe-burn groups was significantly higher than that in the control group; urinary IL-18 concentrations did not differ significantly among the burn and control groups. The AKI group had significantly higher concentrations of urinary KIM-1 and IL-18 than the non-AKI group, both at admission (p = 0.001 and p < 0.001, respectively) and 48 h later (p = 0.001 and p < 0.001, respectively). Both urinary KIM-1 and IL-18 increased before Scr. Receiver operating-curve (ROC) analysis demonstrated that KIM-1 combined with IL-18 predicted AKI with 72.7 % sensitivity and 92.8 % specificity. The area under the ROC curve was 0.904.

Conclusions

Our results suggest that urinary KIM-1 and IL-18 may be used as early, sensitive indicators of AKI in patients with burns of varying degrees and provide clinical clues that can be used in early prevention of AKI.

【 授权许可】

   
2015 Ren et al.

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